.010 Introduction

The terrorist attacks on the World Trade Center have made U.S. residents more concerned about additional threats, both at home and abroad. Terrorist threats have been received at highly visible targets in the U.S. through the mail. University personnel should be on the alert to recognize threats if they appear. The threat of terrorist attacks makes it is easy to become overly worried and suspicious. This procedures document contains information that will reduce faculty, staff, and student anxiety as well as heighten awareness of the potential for a threat.

The Center for Disease Control (CDC), the United States Postal Services (USPS), the Kansas Bureau of Investigation (KBI), the Kansas Department of Health & Environment (KDHE), and the Kansas Department of Administration have developed advisories and procedures to ensure public safety after a bioterrorist threat. Some of these documents can readily be found at www.bt.cdc.gov CDC), www.USPS.com (USPS), and www.kdhe.state.ks.us/han/suspect_packages.htm (KDHE).

In general, if you feel you have received a true terrorist threat, contact the University Police immediately by calling 911 or 532-6412. The dispatch officer on duty will begin an emergency response.

.020 General Procedures Concerning Mail

In all cases, use good common sense in dealing with potential threats.

Inspect all packages received prior to releasing the delivery person. If any damages, discolorations, powder, or wetness is observed, ask the delivery person what else on the truck could have caused the problem

If you receive mail that you are unsure of because it:

is unexpected or from someone unfamiliar to you;

has excessive postage, handwritten or poorly typed address, incorrect titles or titles with no name, or misspellings of common words;

is addressed to someone no longer with your organization or is otherwise outdated;

then immediately place in a double plastic bag and discard the letter in an outside trash receptacle. There is no need to contact the police. Do not bring mail from home that you suspect as contaminated.

.030 Suspicious Materials With No Terroristic Threat

The following procedures should be followed in case you find or receive a suspicious package or letter. First, how do you identify a suspicious letter or package? Some typical characteristics which should trigger suspicion include letters or parcels that:

All of the characteristics in I.D. above could be considered suspicious, especially if you feel you are a target;

have any powdery substance on the outside;

are of unusual weight, given their size, or are lopsided or oddly shaped;

have an unusual amount of security material such as masking tape, packing tape, string, etc.;

have strange odors or stains;

have protruding wires or aluminum foil;

have visual distractions; or

have a ticking sound.

As faculty, staff and students that regularly receive mail from outside the U.S., we are accustomed to receiving letters that resemble some of the characteristics above. These may not necessarily be triggers for us. Use care in opening these letters. If you are concerned that they may harbor a threat, discard the letter in the outside trash. After discarding the letter, use good personal hygiene, i.e., wash your hands, arms, and face with soap and water. Washing your clothes in hot water and detergent will reduce the risk of contracting a disease.

If you find unexplained powders or crystals, use common sense. If called, Public Safety will respond appropriately. One way to avoid a crisis is to clean up spills when you make them. Undisclosed food or chemical spills may become threats if found by an unwary student or staff member. To prevent this, clean up your own spills immediately.

.040 Actual Threats

In case you find or receive a package or letter that is identified as a biological threat, such as anthrax, follow these steps:

do not handle the mail piece or package suspected of contamination; likewise, do not shake or empty the contents of any suspicious envelope or package;

isolate the damaged or suspicious article and keep the immediate area cordoned off;

if possible, place the envelope or package in a clear plastic bag, zip-lock bag, or some other type of container to prevent leakage of contents;

if you do not have a clear container, then COVER the envelope or package with anything (e.g., clothing, paper, trash can, etc.) and do not remove this cover;

LEAVE the room and CLOSE the door, or section off the area to prevent others from entering;

WASH your hands and arms with soap and water to prevent spreading any powder to your face;

call 911 or 532-6412 to report the incident;

list all persons who have touched the letter and/or envelope (include contact information and have this information available for the authorities);

place all items worn when in contact with the suspected mail piece in plastic bags and have them available for law enforcement officials;

as soon as practical, shower with soap and water; and

let Public Safety officials do the rest.

.050 Air Contamination

In some instances, a biological agent may be released to the air or aerosolized. The threat may be a small device such as an aerosol can which will be triggered or a warning that the air handling system is contaminated or a warning that a biological agent was released in a public space. In case of such suspected airborne contamination or aerosolization, follow these steps:

turn off local fans or ventilation units in the area;

Leave area immediately;

Close the door, or section off the area to prevent others from entering (i.e., keep others away);

call 911 or 532-6412 and report the incident;

if possible, Facilities personnel will be asked to shut down the air handling system in the building; and

provide a list of all people who were in the room or area.

.060 Bomb Threat

Another terroristic threat is by bomb. The university has dealt with bomb threats for decades. The current policy on bomb threats still holds true, if you receive a phone call or a note warning of a bomb, take it seriously. Call 911 or 532-6412 and report the incident. The complete policy will be found under "Kansas State University Procedures for Handling Bomb Threats." The following steps should be taken:

Remain Calm. It is rare that a bomb threat caller does not give notice in ample time to insure safety of building occupants.

Listen intently for voice or speech peculiarities and for background noises. Be alert for repeated use of particular words or phrases. Pay close attention to how the caller talks. Peculiarities of speech and voice can aid in later investigations.

"How will the bomb be set off; by time mechanism, oxidizing agent, heat, movement?"

"Why did you place the bomb in this building?"

"May I have your name?"

If possible, keep the caller on the line and have another employee notify the University Police at 911 or 532-6412.

.070 Biological Agents

The following CDC facts concerning anthrax, botulism, pneumonic plague, and small pox are presented to keep university personnel, including students, informed.

Facts about Anthrax. Anthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis. Anthrax most commonly occurs in hoofed mammals and can also infect humans.

Symptoms of disease vary depending on how the disease was contracted, but usually occur within 7 days after exposure. The serious forms of human anthrax are inhalation anthrax, cutaneous anthrax, and intestinal anthrax. Initial symptoms of inhalation anthrax infection may resemble a common cold. After several days, the symptoms may progress to severe breathing problems and shock. Inhalation anthrax is often fatal. The intestinal disease form of anthrax may follow the consumption of contaminated food and is characterized by an acute inflammation of the intestinal tract. Initial signs of nausea, loss of appetite, vomiting, and fever are followed by abdominal pain, vomiting of blood, and severe diarrhea.

Direct person-to-person spread of anthrax is extremely unlikely, if it occurs at all. Therefore, there is no need to immunize or treat contacts of persons ill with anthrax, such as household contacts, friends, or coworkers, unless they were also exposed to the same source of infection. In persons exposed to anthrax, infection can be prevented with antibiotic treatment. Early antibiotic treatment of anthrax is essential-delay lessens chances for survival. Anthrax usually is susceptible to penicillin, doxycycline, and fluoroquinolones. An anthrax vaccine also can prevent infection. Vaccination against anthrax is not recommended for the general public to prevent disease and is not available.

Facts about Botulism. Botulism is a muscle-paralyzing disease caused by a toxin made by the bacterium Clostridium botulinum. There are three main kinds of botulism:

Food borne botulism occurs when a person ingests pre-formed toxin that leads to illness within a few hours to days. Food borne botulism is a public health emergency because the contaminated food may still be available to other persons besides the patient.

Infant botulism occurs in a small number of susceptible infants each year who harbor C. botulinum in their intestinal tract.

Wound botulism occurs when wounds are infected with C. botulinum that secretes the toxin.

Botulism is not spread from one person to another. Food borne botulism can occur in all age groups. A supply of antitoxin against botulism is maintained by CDC. The antitoxin is effective in reducing the severity of symptoms if administered early in the course of the disease. Most patients eventually recover after weeks to months of supportive care.

Facts about Pneumonic Plague. Plague is an infectious disease of animals and humans caused by the bacterium Yersinia pestis. Y. pestis, is found in rodents and their fleas in many areas around the world.

Pneumonic plague occurs when Y. pestis infects the lungs. The first signs of illness in pneumonic plague are fever, headache, weakness, and cough productive of bloody or watery sputum. The pneumonia progresses over 2 to 4 days and may cause septic shock and, without early treatment, death. Person-to-person transmission of pneumonic plague occurs through respiratory droplets, which can only infect those who have face-to-face contact with the ill patient.

Early treatment of pneumonic plague is essential. Several antibiotics are effective, including streptomycin, tetracycline, and chloramphenicol. There is no vaccine against plague. Prophylactic antibiotic treatment for 7 days will protect persons who have had face-to-face contact with infected patients.

Facts about Smallpox. Smallpox infection was eliminated from the world in 1977. Smallpox is caused by variola virus. The incubation period is about 12 days (range: 7 to 17 days) following exposure. Initial symptoms include high fever, fatigue, and head and back aches. A characteristic rash, most prominent on the face, arms, and legs, follows in 2-3 days. The rash starts with flat red lesions that evolve at the same rate. Lesions become pus-filled and begin to crust early in the second week. Scabs develop and then separate and fall off after about 3-4 weeks. The majority of patients with smallpox recover, but death occurs in up to 30% of cases.

Smallpox is spread from one person to another by infected saliva droplets that expose a susceptible person having face-to-face contact with the ill person. Persons with smallpox are most infectious during the first week of illness, because that is when the largest amount of virus is present in saliva. However, some risk of transmission lasts until all scabs have fallen off.

Routine vaccination against smallpox ended in 1972. The level of immunity, if any, among persons who were vaccinated before 1972 is uncertain; therefore, these persons are assumed to be susceptible. Vaccination against smallpox is not available today.

In people exposed to smallpox, the vaccine can lessen the severity of or even prevent illness if given within 4 days after exposure. Vaccine against smallpox contains another live virus called vaccinia. The vaccine does not contain smallpox virus. The U.S. currently has an emergency supply of smallpox vaccine.

There is no proven treatment for smallpox but research to evaluate new antiviral agents is ongoing. Patients with smallpox can benefit from supportive therapy (intravenous fluids, medicine to control fever or pain, etc.) and antibiotics for any secondary bacterial infections that occur.

.080 Questions

Questions are to be directed to the Department of Enviromental Health and Safety, telephone number (785)532-5856.